What Is Spravato® and When Should it Be Used for Depression?

If you’ve been living with major depressive disorder for years, you know how it affects every aspect of your life.

You may even know that several biological, genetic, environmental, and psychological factors contribute to depression. It’s not just a simple case of feeling sad — it’s a complex mental health disorder that requires comprehensive treatment.

And if you’ve sought help for depression, you likely have some experience with talk therapy and antidepressants, both of which successfully alleviate depression symptoms for many people, helping them regain control over their lives — just not for you.

You’re looking for something different, and you’ve come to the right place.

At Revive Holistic Psychiatry in Weymouth, Massachusetts, Dr. Oluranti Adepoju and our team approach depression differently. “Holistic” is in our name because it’s central to our mental health philosophy. 

Holistic means broadening our scope and looking deeper into your circumstances, environment, lifestyle, and history. It means we go way beyond just managing your symptoms; we search relentlessly to uncover and resolve the root cause of your condition. 

Holistic care also means we don’t stop just because one or two traditional treatments haven’t produced results. When we meet a case of treatment-resistant depression (TRD) like yours, we have options, and so do you. 

Introducing Spravato® — a ground-breaking treatment from an old familiar source bringing hope to people with TRD. 

Meet Spravato

Spravato is an FDA-approved innovative treatment for use in adults with major depressive disorder (MDD) who haven’t responded to other treatments. 

It’s a prescription nasal spray that contains esketamine, a chemical cousin of the anesthetic ketamine.

How does Spravato work?

Unlike traditional antidepressants you may have tried that target your monoaminergic system (serotonin, norepinephrine, and dopamine), Spravato acts on your glutamatergic system. It blocks your brain's N-methyl-D-aspartate (NMDA) receptors, which regulate your mood. 

In essence, Spravato restores the broken synaptic connections in your brain cells, alleviating depressive symptoms.

Spravato is a nasal spray

Spravato isn’t a pill but a nasal spray Dr. Adepoju administers in our office. Because Spravato has potential side effects, which can include disorientation and blood pressure changes, you need to take your dose here under our supervision.

Dr. Adepoju may also recommend taking Spravato in conjunction with an oral antidepressant, providing a two-pronged approach to treating depression.

You start with two treatments per week for the first month. Afterward, we may decrease the frequency to once a week or every two weeks based on your response and tolerance to the medication.

When is Spravato warranted?

According to the Food and Drug Administration, Spravato is indicated for use in adults with treatment-resistant depression (TRD), a type of major depressive disorder. This means we use it when you’ve tried at least two different antidepressants during the current depressive episode, but your symptoms haven’t improved significantly.

The criteria for using Spravato include:

Diagnosis of major depressive disorder (MDD)

This serious medical illness affects how you feel, think, and act. It causes intense feelings of sadness and/or a loss of interest in activities you once enjoyed. If you have treatment-resistant depression or major depressive disorder with suicidal thoughts or actions, you may be a good candidate for Spravato.

Inadequate response to previous treatments

We may use Spravato if you haven’t responded to at least two different antidepressants during the current depressive episode.

Adult age

We only recommend Spravato for adults. The FDA hasn’t approved it for children or adolescents due to a lack of studies in these age groups.

Spravato’s efficacy and side effects

Clinical studies have shown that Spravato can start reducing depressive symptoms within 24 hours, with effects lasting up to a week. 

Like all medications, Spravato has potential side effects. These can include nausea, dizziness, increased blood pressure, and hallucinations. For these reasons, Dr. Adepoju closely monitors you following your treatment. 

If you’ve been battling treatment-resistant depression and want to find out if Spravato can help, request an appointment online or call Revive Holistic Psychiatry today.